84 articles - From Friday Jun 03 2022 to Friday Jun 10 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Gastrointest Endosc |
Interventions to improve the performance of upper GI endoscopy quality indicators. To date, data on interventions aimed to improve these indicators are scarce. We systematically reviewed the literature to identify interventions and measures demonstrated to improve the performance of previously established upper endoscopy quality indicators. We also identified evidence gaps and opportunities for improvement in this area. |
| Gut |
| J Hepatol |
EASL Clinical Practice Guidelines on haemochromatosis. The stage of liver fibrosis and other end-organ damage should be carefully assessed at diagnosis because they determine disease management. Patients with advanced fibrosis should be included in a screening programme for hepatocellular carcinoma. Treatment targets for phlebotomy are ferritin <50 µg/L during the induction phase and <100 µg/L during the maintenance phase. |
meta-analyses and systematic reviews
| Endoscopy |
THE ROLE OF PANCREATOSCOPY IN THE DIAGNOSTIC WORK-UP OF INTRA-DUCTAL PAPILLARY MUCINOUS NEOPLASMS: A SYSTEMATIC REVIEW AND META ANALYSIS. POP is technically successful in the vast majority of patients with (suspected) IPMN, has a considerably high diagnostic accuracy, but an adverse event rate of 12%. Data on intraoperative pancreatoscopy is scarce, but small studies suggest its use can alter surgical management. Future studies are needed to better define the role of POP in the diagnostic work-up of IPMN. |
| Gastrointest Endosc |
Clip Closure to Prevent Adverse Events Following Endoscopic Mucosal Resection of Proximal Large Non-pedunculated Colorectal Polyps: Meta-analysis of Individual Patient Data from Randomized Controlled Trials. Prophylactic clipping is efficacious in preventing CSPEB after EMR of proximal LNPCPs. Therefore, clip closure should be considered a standard component of EMR of LNPCPs in the proximal colon. |
| J Crohns Colitis |
Faecal metabolomics in paediatric inflammatory bowel disease: a systematic review. This systematic review provides evidence for distinct faecal metabolomic profiles in paediatric IBD. However, results varied across studies, possibly due to differences in study design and applied analytical techniques. Faecal metabolomics could provide more insight into host-microbial interactions in IBD, but further studies with standardised methodologies and reporting are needed. |
| J Hepatol |
Carvedilol reduces the risk of decompensation and mortality in patients with compensated cirrhosis in a competing-risk meta-analysis. Long-term carvedilol therapy reduced decompensation of cirrhosis and significantly improved survival in compensated patients with CSPH. This suggests that screening patients with compensated cirrhosis for CSPH to start therapy with carvedilol can improve outcomes. |
| Neurogastroenterol Motil |
Normative values for esophageal functional lumen imaging probe measurements: A meta-analysis. Given these observations, we recommend using a cut-off of 2mm 2 /mmHg for clinical practice, values below can be considered abnormal. Given that 5.4% of the healthy subjects will have an EGJ-DI below 2mm 2 /mmHg at 40ml, we recommend using the 50 and 60ml distention volumes. The clinical use of an upper limit for normality of EGJ-DI seems questionable. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Clinical trial: a controlled trial of baclofen add-on therapy in PPI-refractory gastro-oesophageal reflux symptoms. Baclofen decreases several reflux parameters in PPI refractory GERD symptoms, but pH-impedance monitoring is necessary before treatment as only SAP+ patients experience clinical benefit after 4weeks. |
Home-based, tunnelled peritoneal drainage system as an alternative treatment option for patients with refractory ascites. The implant of PeCa allows home-based therapy of RA in patients with liver cirrhosis and contraindication for TIPS. However, the risk for complications such as AKI or hyponatraemia has to be considered and prospective studies are needed. |
Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohn's disease. Elevated degradation of type I, III and IV collagen and excessive (relative) formation of type IV collagen strongly associates with stricturing CD. Type I and IV collagen fragments show predictive potential for the risk of penetrating disease progression. These biomarkers may become valuable tools for detection and prediction of stricturing and penetrating CD. |
| Clin Gastroenterol Hepatol |
| Endoscopy |
Bite-on-bite biopsies for the detection of residual esophageal cancer after neoadjuvant chemoradiotherapy. A second (bite-on-bite) biopsy improves the detection of residual esophageal cancer by almost 20 percentage points, at the expense of increasing the false-positive rate by 3 percentage points. The higher detection rate is explained by the higher number of biopsies obtained rather than by the penetration depth. |
Digital single operator pancreatoscopy for the treatment of symptomatic pancreatic duct stones. A prospective multicenter cohort trial. DSOP guided endotherapy is effective and safe for treatment of symptomatic MPD stones in highly selected patients with CP. It significantly reduces pain and could be considered as an alternative to standard ERCP techniques for MPD stone treatment in these patients. |
What size cutoff level should be used to implement optical polyp diagnosis? Surveillance interval agreements between pathology and optical diagnosis for the three groups were 97.2%, 95.5%, and 94.2%, respectively. Total reductions in pathology examinations for the three groups were 33.5%, 62.3%, and 78.2%, respectively. CONCLUSION : A 3-mm cutoff for clinical implementation of optical diagnosis resulted in a very low risk of delayed management of advanced neoplasia while showing high surveillance interval agreement with pathology and a one-third reduction in overall requirement for pathology examinations. |
| Gastroenterology |
Metabolome changes with diet-induced remission in pediatric Crohn's disease. CDED+PEN- and EEN-induced remission are associated with significant changes in IBD-associated metabolites such as kynurenine, ceramides, amino acids and others. Sustained remission with CDED+PEN, but not EEN, was associated with persistent changes in metabolites. ClincialTrials.gov number, NCT01728870. |
The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: New estimates from GLOBOCAN 2020. These updated estimates of the global burden of esophageal cancer represent an important baseline for setting priorities in policymaking and developing and accelerating cancer control initiatives to reduce the current and projected burden. While primary prevention continues to remain key, screening and early detection represent important components of esophageal cancer control in high-risk populations. |
Uncovering 1,058 novel human enteric DNA viruses through deep long-read third-generation sequencing and their clinical impact. We uncovered 1,058 novel human gut viruses. These findings can contribute to clinical diagnosis, current viral reference genome and future virome investigation. |
Vonoprazan Triple and Dual Therapy for Helicobacter pylori Infection in the US and Europe: Randomized Clinical Trial. Both vonoprazan-based regimens were superior to PPI-based triple therapy in clarithromycin-resistant strains and in the overall study population. ; NCT04167670. |
| Gastrointest Endosc |
Aerosol and droplet generation in upper and lower gastrointestinal endoscopy: whole procedure and event-based analysis. Gastrointestinal endoscopy performed via the mouth, nose or rectum al generates significant quantities of aerosols and droplets. As the infectivity of procedures is not established, we therefore suggest adequate PPE is used for al GI endoscopy where there is a high population prevalence of COVID-19. Avoiding throat and nasal spray would significantly reduce particles generated from UGI procedures. |
Impact of endobiliary radiofrequency ablation on biliary drainage in patients with malignant biliary strictures treated with uncovered self-expandable metal stents: a randomized controlled multicenter-trial. RFA as an addition to SEMS-implantation had no positive impact on patency rate or survival. |
Submucosal tunneling endoscopic septum division for esophageal diverticulum with a median follow-up of 39 months: a multicenter cohort study. STESD is a safe and valid endoscopic minimally invasive surgery for esophageal diverticulum, which can reduce symptoms and improve quality of life. |
| Hepatology |
Access to Technology to Support Telehealth in Areas without Specialty Care for Liver Disease. Areas with poor access to liver disease specialty care have a greater burden of liver-related mortality, and many of their residents lack access to technology. Therefore, a telehealth strategy based solely on patient device ownership and internet access will exclude a large proportion of individuals in the areas of highest need. Further work should be done at the local and state levels to design optimal strategies to reach their populations of need. |
| Inflamm Bowel Dis |
David Against Goliath: Direct Comparison of Handheld Bowel Sonography and Magnetic Resonance Enterography for Diagnosis of Crohn's Disease. Handheld bowel sonography and MRE are 2 accurate and noninvasive procedures for diagnosis of CD, although MRE is more sensitive in defining extension, location, and complications. Handheld bowel sonography could be used as effective ambulatory (or out-of-office) screening tool for identifying patients to refer for MRE examination due to high probability of CD diagnosis. |
Feasibility of a Clinical Decision Support Tool for Ustekinumab to Predict Clinical Remission and Relapse in Patients With Crohn's Disease: A Multicenter Observational Study. The UST-CDST can predict clinical relapse in patients with moderate to severe CD subjected to ustekinumab therapy. |
Identifying the Presence, Activity, and Status of Extraintestinal Manifestations of Inflammatory Bowel Disease Using Natural Language Processing of Clinical Notes. NLP methods can both detect and infer the activity status of EIMs using the medical document an information source. Though source document variation and ambiguity present challenges, NLP offers exciting possibilities for population-based research and decision support in IBD. |
Mindfulness Intervention Decreases Frequency and Severity of Flares in Inactive Ulcerative Colitis Patients: Results of a Phase II, Randomized, Placebo-Controlled Trial. MIs could be considered as adjuvant treatment for a subset of UC patients with high perceived stress and low state of mindfulness.The trial was registered at clinicaltrials.gov as NCT01491997. |
| J Crohns Colitis |
Targeted Assessment of Mucosal Immune Gene Expression Predicts Clinical Outcomes in Children with Ulcerative Colitis. Targeted assessment of rectal mucosal immune gene expression predicts 52-week CSFR in treatment-naïve pediatric UC patients. Further exploration of IL-13R2 as a therapeutic target in UC, and future studies of the epithelial-specific role of RORC in UC pathogenesis are warranted. |
| Neurogastroenterol Motil |
Gene expression and clinical outcomes after dietary treatment: A prospective study. These findings strongly suggest that elimination diets, besides a clinical and histological response, are associated with a broad transcriptional response at the level of the esophageal epithelium. |
Normative values of intra-bolus pressure and esophageal compliance based on 4D high-resolution impedance manometry. 4D-HRIM provides a standardized methodology to track the nadir impedance and provide measurements of IBP during maximal distention across phases 1-3 of bolus transit. Median IBP and delta IBP were different across the phases, supporting the need to define IBP by phase. Additionally, the EGJ-DI calculated during phase 3 was similar to the 60-ml EGJ-DI from FLIP in the same subjects suggesting that 4D-HRIM can quantify EGJ opening during primary peristalsis. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Diagnostic and therapeutic approach to persistent abdominal pain beyond irritable bowel syndrome. Persistent abdominal pain (PAP) is a challenging condition to diagnose and treat. Many patients undergo repeated diagnostic testing and treatment, including surgery, without achieving symptom relief. Increasing physician awareness of the various causes of PAP, especially of rare diseases that are less well known, may improve patient outcomes. |
Review: Vascular effects of PPARs in the context of NASH. Aim This review summarises and discusses the pathobiological role of PPARs in cardiovascular diseases with a special focus on their impact and therapeutic potential in NAFLD and NASH. Results and conclusions PPARs may be attractive for the treatment of NASH due to their liver-specific effects but also because of their efficacy in improving cardiovascular outcomes, which may later impact liver disease. Assessment of cardiovascular disease in the context of NASH trials is, therefore, of the utmost importance, both from a safety and efficacy perspective. |
| Gastroenterology |
| Gastrointest Endosc |
Robotics in Therapeutic Endoscopy: Where We Are and Where Are We Going? (with video). The incorporation of robotics in gastroenterology initially aimed to address shortcomings of flexible endoscopes in natural orifice transluminal endoscopy. Developing therapeutic endoscopic robotic platforms now offer operators improved ergonomics, visualization, dexterity, precision, and control and the possibility of increasing proficiency and standardization of complex endoscopic procedures including endoscopic submucosal dissection, endoscopic full thickness resection, and endoscopic suturing. The following review discusses the history, potential applications, and tools that are currently available and in development for robotics in therapeutic endoscopy. |
| Hepatology |
Rethinking the management of pain in cirrhosis: toward precision therapy for pain. However, there is limited guidance on appropriate pain management in this population, and pharmacologic treatment can be harmful, leading to adverse outcomes, such as GI bleeding, renal injury, falls, and hepatic encephalopathy. Chronic pain can be categorized mechanistically into three pain types: nociceptive, neuropathic, and nociplastic, each responsive to different therapies. By discussing the identification, etiology, and treatment of these three mechanistic pain descriptors with a focus on specific challenges in patients with cirrhosis, we provide a framework for better tailoring treatments, including non-pharmacologic therapies, to patients' needs. |
The role of TIPS in patients with cirrhosis and ascites: recent evolution and open questions. The combination of these factors is important to guide clinical decision making and identify the best strategy for each individual patient. There is still a need to identify the best timing for TIPS placement in the natural history of ascites (recurrent vs refractory) as well as which type and level of renal dysfunction is acceptable when TIPS is proposed for the treatment of ascites in cirrhosis. Future studies are needed to define the optimal stent diameter according to patient characteristics and individual risk of shunt-related side-effects, particularly hepatic encephalopathy and insufficient cardiac response to hemodynamic consequences of TIPS insertion. |
| Inflamm Bowel Dis |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| Inflamm Bowel Dis |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gut |
| Inflamm Bowel Dis |
| J Hepatol |